Dermoscopic evaluation of nail changes in alopecia areata

Abstract

Background Alopecia areata (AA) is an immune-mediated disease that is characterized by nonscarring hair loss. In the majority of cases, hair falls out in one or more well-circumscribed round or oval patches on the scalp or body (AA focalis), but sometimes it can lead to complete loss of hair on the scalp (AA totalis) or, in extreme cases, the entire body (AA universalis). Hair and nails have a common origin, anatomical structures, and may be involved in many diseases. Nails may also be involved in AA; fragility and pitting can be signs of nail dystrophy in AA patients. Nail dermoscopy was initially used only in the assessment of nail pigmentation, but now it is widely utilized for the evaluation and follow-up of many nail disorders. Aim Evaluation of the presence, types, and clinical findings of nail changes in patients with AA by nail dermoscopy. Patients and methods This is a cross-section observational study, including 100 patients with AA. They were subjected to complete history taking, clinical examination (general and dermatological), and the severity of alopecia tool score was calculated for all patients. The finger nail was examined with a dermoscope to clarify the features of nail changes associated with the disease. Results Nail changes were found in (84.0%) of patients of AA, while (16.0%) have not shown nail changes. The most common nail change was scaly cuticle (75%) of the patients. There was a highly significant positive correlation between nail changes in patients having AA with severity of alopecia tool score and duration of the disease. There was no statistical significant correlation regarding sex, age of the patients, and dermoscopic hair features of AA. Conclusions From this study, we have found that scaly cuticle is the most common nail change in AA patients followed by scales in the lateral nail fold. Also, it can be concluded that nail changes in AA related to the disease severity and the duration of disease, but they are not related to the age, sex of patients, and dermoscopic findings of AA.